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People with diabetes at greater risk of heart failure

People with diabetes are 65% more likely to have heart failure than the general population in England and Wales, according to results from a recent audit.1

They are also at a much greater risk of potentially fatal conditions such as myocardial infarction, angina and stroke and of needing amputations, according to the National Diabetes Audit, which analysed the care of nearly two million people with diabetes in 2010/11 in England and Wales.

The audit is managed by the Health and Social Care Information Centre (HSCIC) in partnership with Diabetes UK and commissioned by the Healthcare Quality Improvement Partnership (HQIP).

Its latest findings also show that people with diabetes in England and Wales are:

48% more likely to suffer a myocardial infarction: 14,500 people with diabetes suffered this complication in 2010/11 – when 9,800 of such cases were expected

25% more likely to suffer a stroke: 17,900 people with diabetes suffered this complication in 2010/11 – when 14,300 of such cases were expected

144% more likely to need renal replacement therapy: 9,800 people with diabetes needed this treatment in 2010/11 – when 4,000 were expected

331% more likely to need a minor amputation: 3,000 people needed this treatment in 2010/11 – when 700 of such cases were expected

210% more likely to need a major amputation: 1,700 people with diabetes suffered this complication in 2010/11 – when 600 of such cases were expected

40% more likely to die than the general population: 65,700 people with diabetes died in 2011 – when 47,000 such deaths were expected. Taking into account patients not captured in the audit, it is estimated there were 22,200 excess deaths in England and 1,900 in Wales among people with diabetes

The excess risk is much higher among people with type 1 diabetes – 135%, compared to 36% for people with type 2 diabetes. For patients captured in the audit, this equates to 3,100 people with type 1 diabetes dying in 2011 when 1,300 such deaths were expected, and 60,900 people with type 2 diabetes dying when 44,600 deaths were expected

Women with diabetes were at a greater relative risk of death than men with the condition: at 142% for type 1 and 40% for type 2 for women, compared to 130% and 33% respectively for men.

Audit lead clinician Dr Bob Young (National Diabetes Information Service) said: “These results highlight the huge impact of diabetes on disability and premature death. Much can be done to reduce these risks if all health care sectors work together with people who have diabetes. Some districts have appreciably lower diabetes related complications than others. Improving treatment for diabetes should be a top priority for all clinical services.”